Rehabilitation Global Needs: Difference between revisions
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Rehabilitation is is a critical health strategy to optimise everyday functioning and ensure the highest possible standard of health and well-being and can include exercise, balance training, home modification, sensory integration, community activities, mobility aids, prosthetics/orthotics and many other interventions.<ref>Key Facts: Rehabilitation. World Health Organization, Geneva. 2020. {Accessed October 11, 2020 <nowiki>https://www.who.int/news-room/fact-sheets/detail/rehabilitation}</nowiki></ref> | Rehabilitation is is a critical health strategy to optimise everyday functioning and ensure the highest possible standard of health and well-being and can include exercise, balance training, home modification, sensory integration, community activities, mobility aids, prosthetics/orthotics and many other interventions.<ref>Key Facts: Rehabilitation. World Health Organization, Geneva. 2020. {Accessed October 11, 2020 <nowiki>https://www.who.int/news-room/fact-sheets/detail/rehabilitation}</nowiki></ref> | ||
Rehabilitation interventions optimize well-being by addressing impairments, limitations, and restrictions in many areas (mobility, vision, and cognition) while considering personal and environmental factors.<ref name=":1">Mills JA, Marks E, Reynolds T, Cieza A. Rehabilitation: essential along the continuum of care</ref> The need for rehabilitation depends on timing, type of intervention that a rehabilitation provider selects, aetiology and severity of the person’s health condition, the prognosis, the way in which illness affects the person’s ability to function in the environment, as well as the individual’s identified personal goals.<ref name=":1" /> These services may be required throughout their lifespan by persons with health conditions. | Rehabilitation interventions optimize well-being by addressing impairments, limitations, and restrictions in many areas (mobility, vision, and cognition) while considering personal and environmental factors.<ref name=":1">Mills JA, Marks E, Reynolds T, Cieza A. Rehabilitation: essential along the continuum of care</ref> The need for rehabilitation depends on timing, type of intervention that a rehabilitation provider selects, aetiology and severity of the person’s health condition, the prognosis, the way in which illness affects the person’s ability to function in the environment, as well as the individual’s identified personal goals.<ref name=":1" /> These services may be required throughout their lifespan by persons with health conditions. Despite its individual and societal benefits, rehabilitation has not been prioritised in countries and is under-resourced. | ||
Despite its individual and societal benefits, rehabilitation has not been prioritised in countries and is under-resourced. | |||
[[Category:Understanding Rehabilitation Content Development Project]] | [[Category:Understanding Rehabilitation Content Development Project]] | ||
[[Category:Rehabilitation]] | [[Category:Rehabilitation]] | ||
== Growing Demand for Rehabilitation Services == | == Growing Demand for Rehabilitation Services == | ||
In the 21st century rapid population ageing accompanied with a rise in chronic conditions, trauma/injury survival and non-communicable diseases (NCD) in conjunction with increasing global conflict, rapid urbanization and motorization are leading to a rapid shift in health care needs.<ref>World Health Organization, The World Bank. World report on disability. Geneva: World Health Organization; 2011. </ref> Hence, rehabilitation needs will further increase in the years to come, which is a considerable challenge for health and social systems.<ref name=":0" /> | |||
According to the Global Burden of Disease Study in 2019 2·41 billion individuals had conditions that would benefit from rehabilitation, contributing to 310 million years of life lived with disability (YLDs). This has increased by 63% from 1990 to 2019, although age-standardised prevalence and YLDs rates showed modest declines since 1990, indicating that the large increase in cases is due to population growth and more specifically population ageing.<ref name=":0">Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020 Dec 19;396(10267):2006-17.</ref> If we consider this in terms of gender, prevalence of a condition with rehabilitation needs was almost equal in men (1·19 billion) and women (1·22 billion), although women present with more YLDs (163 million) in comparison to men (146 million). | |||
=== Age Considerations === | |||
According to the world data published in 2019, life expectancy has continued to increase globally with a 6 year increase seen alone between 2000 and 2019; from 66.8 years in 2000 to 73.4 years in 2019.<ref name=":4">World Health Organisation - Global Health Observatory. Global Health Estimates: Life Expectancy and Leading Causes of Death and Disability. Available from: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates (accessed 20/06/2021)</ref> Generally people can now expect to live more than twice as long as our ancestors, and this progress is seen in every world region.<ref>Roser M, Ortiz-Ospina E, Ritchie H. Life expectancy. Our World in Data. 2013 May 23.</ref> According to WHO, the number of people over 60 years of age is predicted to double by 2050, with more people living with chronic diseases such as diabetes, stroke, and cancer. <ref name=":2">World Health Organisation. Rehabilitation. Available from: https://www.who.int/news-room/fact-sheets/detail/rehabilitation (accessed on 12 Jan 2021)</ref> | |||
As expected if we consider rehabilitation needs in relation to an ageing population, the age where we see the greatest need both in terms of prevalence and YLDs is in people aged 50-70 years, while we see the lowest need for rehabilitation services in those aged 95 years and older. Musculoskeletal disorders, neurological disorders, sensory impairments, and chronic respiratory diseases were the largest contributors for those aged >65 years, while mental disorders and musculoskeletal disorders accounted for a smaller proportion than in comparison to adults younger than 65 years. <ref name=":0" /> | |||
The potential benefits of rehabilitation services are not restricted to aging and adult populations. Children constitute a significant and important portion of users of rehabilitation services. According to WHO, while child mortality rates are declining, not all who survive thrive.<ref name=":4" /> Early interventions that optimize developmental outcomes for children with various health conditions and injuries (including congenital, acquired, neurological, orthopaedic, musculoskeletal and cognitive impairments) can positively affect participation rates in education, community activities, and future capacity to work. If we consider children younger than 15 years, sensory impairments, mental disorders, and musculoskeletal disorders accounted for 91% of the 162·3 million prevalent cases of children who have rehabilitation needs. <ref name=":0" /> | |||
=== Condition Considerations === | |||
Musculoskeletal disorders account for a significant number of those individuals who have a need for rehabilitation services at 1·71 billion people, with low back pain the most prevalent condition requiring access to rehabilitation services in 134 of the 204 countries analysed. <ref name=":0" /> In those aged 15–64 years, 1600 million have a condition that would benefit from rehabilitation in 2019, with musculoskeletal disorders contributing to approximately two-thirds of this number. <ref name=":0" /> | |||
=== Non-Communicable Diseases === | === Non-Communicable Diseases === | ||
Noncommunicable diseases (NCDs), also known as chronic diseases differ significantly from acute conditions and require a different approach to the disease's complexity and frequent requirements for continuing care. The World Health Organization estimates that 50% of the global disease burden is due to chronic illness. Since chronic diseases are long-lasting, conditions do have compounding and sustained effects on the individual and broader society's social, physical, psychological, and economic levels. Chronic diseases cost billions of dollars in direct healthcare costs and also in productivity losses. <ref>MacIntosh E, Rajakulendran N, Khayat Z, Wise A. Transforming health: Shifting from reactive to proactive and predictive care. Toronto: MaRS Discovery District. Accessed: Jul. 15, 2018.</ref> | Noncommunicable diseases (NCDs), also known as chronic diseases differ significantly from acute conditions and require a different approach to the disease's complexity and frequent requirements for continuing care. The World Health Organization estimates that 50% of the global disease burden is due to chronic illness. Since chronic diseases are long-lasting, conditions do have compounding and sustained effects on the individual and broader society's social, physical, psychological, and economic levels. Chronic diseases cost billions of dollars in direct healthcare costs and also in productivity losses. <ref>MacIntosh E, Rajakulendran N, Khayat Z, Wise A. Transforming health: Shifting from reactive to proactive and predictive care. Toronto: MaRS Discovery District. Accessed: Jul. 15, 2018.</ref> | ||
=== Other Health Conditions === | === Other Health Conditions === | ||
The ongoing incidence of injury (such as burns), the occurrence of natural calamities (earthquakes/floods), disease outbreaks, human-induced hazards (conflict, terrorism, or industrial accidents) can create overwhelming rehabilitation needs due to injury or illness. They affect existing services and significantly impact the most vulnerable populations and the weakest health systems.<ref name=":2" /> | The ongoing incidence of injury (such as burns), the occurrence of natural calamities (earthquakes/floods), disease outbreaks, human-induced hazards (conflict, terrorism, or industrial accidents) can create overwhelming rehabilitation needs due to injury or illness. They affect existing services and significantly impact the most vulnerable populations and the weakest health systems.<ref name=":2" /> | ||
=== Region Considerations === | |||
The highest needs for rehabilitation services were seen in the Western Pacific Region, with 610 million people, which accounts for 83 million YLDs. | |||
=== Socioeconomic Impact of Poverty === | === Socioeconomic Impact of Poverty === | ||
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{{#ev:youtube|Wu5EraB6Qdw|250}} <div class="row"><div class="col-md-6 col-md-offset-3"><div class="text-right"><ref>World Health Organisation (WHO). Release of the Global Estimates of the Need for Rehabilitation. Available from: https://youtu.be/Wu5EraB6Qdw[last accessed 26/06/21]</ref></div></div></div> | {{#ev:youtube|Wu5EraB6Qdw|250}} <div class="row"><div class="col-md-6 col-md-offset-3"><div class="text-right"><ref>World Health Organisation (WHO). Release of the Global Estimates of the Need for Rehabilitation. Available from: https://youtu.be/Wu5EraB6Qdw[last accessed 26/06/21]</ref></div></div></div> | ||
== Conclusion == | |||
As we have shown evidence suggests that rehabilitation is needed by 2·41 billion people globally, who present with a wide variety of health conditions and rehabilitation needs that cross the lifespan. There is also emerging evidence that many of the people affected by the COVID-19 pandemic also have long-term consequences regardless of their initial disease severity or length of hospitalisation, thus increasing the demand for rehabilitation services globally even further since the global burden of disease study in 2019. It is evident that to meet these rehabilitation needs requires integration of rehabilitation services into health systems and specifically, for rehabilitation services to be strengthened at the primary care level, where people will benefit from rehabilitation close to home. A strong primary care system, where diagnosis of most health conditions, identification of problems in functioning, referral to specialised service delivery platforms, and adherence to treatment plans are available is key to overcoming some of the gaps in provision of rehabilitation services, especially in many low-income and middle-income countries Promoting these functions of primary care will ensure that a life-course and integrated perspective on care is achieved, thus improving the functioning and quality of life of the population. <ref name=":0" /> | |||
Regardless of who the beneficiary is, who delivers it, or the context in which rehabilitation is delivered, optimising functioning is the ultimate objective of rehabilitation and is instrumental to a patient's wellbeing, regardless of the underlying health condition. With a global ageing population who live longer as a result of advances in preventive strategies and medical interventions, but often with more disability, functioning needs urgent attention and rehabilitation plays a key part in ensuring this. <ref name=":0" /> | |||
== Resources == | == Resources == | ||
* | * [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32340-0/fulltext Global Estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019]. The Lancet. 2020 Dec 1. | ||
== References == | == References == | ||
<references /> | <references /> | ||
Revision as of 15:46, 27 June 2021
Original Editors - Naomi O'Reilly and Vidya Acharya
Top Contributors - Naomi O'Reilly, Kim Jackson, Vidya Acharya, Jess Bell, Oyemi Sillo, Tarina van der Stockt, Lucinda hampton, Ashmita Patrao and Ewa Jaraczewska
Introduction[edit | edit source]
Rehabilitation is the care needed when a person is experiencing or is likely to experience limitations in everyday functioning due to aging or a health condition, including chronic diseases or disorders, injuries, or trauma. According to the World Health Organization (WHO), rehabilitation is defined as a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions interacting with their environment.
Rehabilitation is is a critical health strategy to optimise everyday functioning and ensure the highest possible standard of health and well-being and can include exercise, balance training, home modification, sensory integration, community activities, mobility aids, prosthetics/orthotics and many other interventions.[1]
Rehabilitation interventions optimize well-being by addressing impairments, limitations, and restrictions in many areas (mobility, vision, and cognition) while considering personal and environmental factors.[2] The need for rehabilitation depends on timing, type of intervention that a rehabilitation provider selects, aetiology and severity of the person’s health condition, the prognosis, the way in which illness affects the person’s ability to function in the environment, as well as the individual’s identified personal goals.[2] These services may be required throughout their lifespan by persons with health conditions. Despite its individual and societal benefits, rehabilitation has not been prioritised in countries and is under-resourced.
Growing Demand for Rehabilitation Services[edit | edit source]
In the 21st century rapid population ageing accompanied with a rise in chronic conditions, trauma/injury survival and non-communicable diseases (NCD) in conjunction with increasing global conflict, rapid urbanization and motorization are leading to a rapid shift in health care needs.[3] Hence, rehabilitation needs will further increase in the years to come, which is a considerable challenge for health and social systems.[4]
According to the Global Burden of Disease Study in 2019 2·41 billion individuals had conditions that would benefit from rehabilitation, contributing to 310 million years of life lived with disability (YLDs). This has increased by 63% from 1990 to 2019, although age-standardised prevalence and YLDs rates showed modest declines since 1990, indicating that the large increase in cases is due to population growth and more specifically population ageing.[4] If we consider this in terms of gender, prevalence of a condition with rehabilitation needs was almost equal in men (1·19 billion) and women (1·22 billion), although women present with more YLDs (163 million) in comparison to men (146 million).
Age Considerations[edit | edit source]
According to the world data published in 2019, life expectancy has continued to increase globally with a 6 year increase seen alone between 2000 and 2019; from 66.8 years in 2000 to 73.4 years in 2019.[5] Generally people can now expect to live more than twice as long as our ancestors, and this progress is seen in every world region.[6] According to WHO, the number of people over 60 years of age is predicted to double by 2050, with more people living with chronic diseases such as diabetes, stroke, and cancer. [7]
As expected if we consider rehabilitation needs in relation to an ageing population, the age where we see the greatest need both in terms of prevalence and YLDs is in people aged 50-70 years, while we see the lowest need for rehabilitation services in those aged 95 years and older. Musculoskeletal disorders, neurological disorders, sensory impairments, and chronic respiratory diseases were the largest contributors for those aged >65 years, while mental disorders and musculoskeletal disorders accounted for a smaller proportion than in comparison to adults younger than 65 years. [4]
The potential benefits of rehabilitation services are not restricted to aging and adult populations. Children constitute a significant and important portion of users of rehabilitation services. According to WHO, while child mortality rates are declining, not all who survive thrive.[5] Early interventions that optimize developmental outcomes for children with various health conditions and injuries (including congenital, acquired, neurological, orthopaedic, musculoskeletal and cognitive impairments) can positively affect participation rates in education, community activities, and future capacity to work. If we consider children younger than 15 years, sensory impairments, mental disorders, and musculoskeletal disorders accounted for 91% of the 162·3 million prevalent cases of children who have rehabilitation needs. [4]
Condition Considerations[edit | edit source]
Musculoskeletal disorders account for a significant number of those individuals who have a need for rehabilitation services at 1·71 billion people, with low back pain the most prevalent condition requiring access to rehabilitation services in 134 of the 204 countries analysed. [4] In those aged 15–64 years, 1600 million have a condition that would benefit from rehabilitation in 2019, with musculoskeletal disorders contributing to approximately two-thirds of this number. [4]
Non-Communicable Diseases[edit | edit source]
Noncommunicable diseases (NCDs), also known as chronic diseases differ significantly from acute conditions and require a different approach to the disease's complexity and frequent requirements for continuing care. The World Health Organization estimates that 50% of the global disease burden is due to chronic illness. Since chronic diseases are long-lasting, conditions do have compounding and sustained effects on the individual and broader society's social, physical, psychological, and economic levels. Chronic diseases cost billions of dollars in direct healthcare costs and also in productivity losses. [8]
Other Health Conditions[edit | edit source]
The ongoing incidence of injury (such as burns), the occurrence of natural calamities (earthquakes/floods), disease outbreaks, human-induced hazards (conflict, terrorism, or industrial accidents) can create overwhelming rehabilitation needs due to injury or illness. They affect existing services and significantly impact the most vulnerable populations and the weakest health systems.[7]
Region Considerations[edit | edit source]
The highest needs for rehabilitation services were seen in the Western Pacific Region, with 610 million people, which accounts for 83 million YLDs.
Socioeconomic Impact of Poverty[edit | edit source]
Poverty is closely associated with NCDs. Lack of access to health care and screening for conditions and also lack of disease-prevention efforts put people in low-income countries at higher risk of dying from non-communicable disease as well as infectious disease.[9][10]
The non-communicable disease threatens progress towards the 2030 Agenda for Sustainable Development, which includes a target of reducing premature deaths from NCDs by one-third by 2030.[9] Widespread availability of rehabilitation services is essential for health systems to be able to respond effectively to the needs of older populations. Numerous studies have concluded that community-based rehabilitation increases the safety and independence of older people, reduces the risk of falls, and decreases the need for hospital and nursing home admissions. [2]
Conclusion[edit | edit source]
As we have shown evidence suggests that rehabilitation is needed by 2·41 billion people globally, who present with a wide variety of health conditions and rehabilitation needs that cross the lifespan. There is also emerging evidence that many of the people affected by the COVID-19 pandemic also have long-term consequences regardless of their initial disease severity or length of hospitalisation, thus increasing the demand for rehabilitation services globally even further since the global burden of disease study in 2019. It is evident that to meet these rehabilitation needs requires integration of rehabilitation services into health systems and specifically, for rehabilitation services to be strengthened at the primary care level, where people will benefit from rehabilitation close to home. A strong primary care system, where diagnosis of most health conditions, identification of problems in functioning, referral to specialised service delivery platforms, and adherence to treatment plans are available is key to overcoming some of the gaps in provision of rehabilitation services, especially in many low-income and middle-income countries Promoting these functions of primary care will ensure that a life-course and integrated perspective on care is achieved, thus improving the functioning and quality of life of the population. [4]
Regardless of who the beneficiary is, who delivers it, or the context in which rehabilitation is delivered, optimising functioning is the ultimate objective of rehabilitation and is instrumental to a patient's wellbeing, regardless of the underlying health condition. With a global ageing population who live longer as a result of advances in preventive strategies and medical interventions, but often with more disability, functioning needs urgent attention and rehabilitation plays a key part in ensuring this. [4]
Resources[edit | edit source]
- Global Estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020 Dec 1.
References [edit | edit source]
- ↑ Key Facts: Rehabilitation. World Health Organization, Geneva. 2020. {Accessed October 11, 2020 https://www.who.int/news-room/fact-sheets/detail/rehabilitation}
- ↑ 2.0 2.1 2.2 Mills JA, Marks E, Reynolds T, Cieza A. Rehabilitation: essential along the continuum of care
- ↑ World Health Organization, The World Bank. World report on disability. Geneva: World Health Organization; 2011.
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020 Dec 19;396(10267):2006-17.
- ↑ 5.0 5.1 World Health Organisation - Global Health Observatory. Global Health Estimates: Life Expectancy and Leading Causes of Death and Disability. Available from: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates (accessed 20/06/2021)
- ↑ Roser M, Ortiz-Ospina E, Ritchie H. Life expectancy. Our World in Data. 2013 May 23.
- ↑ 7.0 7.1 World Health Organisation. Rehabilitation. Available from: https://www.who.int/news-room/fact-sheets/detail/rehabilitation (accessed on 12 Jan 2021)
- ↑ MacIntosh E, Rajakulendran N, Khayat Z, Wise A. Transforming health: Shifting from reactive to proactive and predictive care. Toronto: MaRS Discovery District. Accessed: Jul. 15, 2018.
- ↑ 9.0 9.1 World Health Organisation. Noncommunicable Diseases. Available from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases (accessed 21 Jan 2021)
- ↑ Patrick Smith A Vicious Circle: Poverty and Noncommunicable Diseases
- ↑ World Health Organisation (WHO). Release of the Global Estimates of the Need for Rehabilitation. Available from: https://youtu.be/Wu5EraB6Qdw[last accessed 26/06/21]
